Blockchain and Healthcare
Healthcare industry is fragmented at both national and international level. Indeed each country has its own healthcare system. However, in almost all jurisdictions, there are both private and public entities operating in the industry and they prefer hiding patient information to themselves. In fact, some private hospitals do not grant free access to patients themselves.
What is the problem with this? We classify the problems under two main sub-groups:
- Efficiency: The current system is far from being efficient and it requires repetitions. If you are seeing a new doctor, you have to provide him/her with your medical history manually, which might not be accurate or even available. You might have to go through the same examinations at different hospitals over and over again, which is waste of time and resources. Or, you might be in another country, experiencing a health problem and in a need to explain your medical situation to a foreign doctor. In a more crucial scenario, you might not be conscious at all.
- Control on the information: In the current system the patient, individual hospitals are in control and patients do not have control on their own personal information. With the expectation of getting the medical assistance, people give their personal information without thinking on it. Hospitals gather too much personal information without being accountable for what they do with that information. Since patients sign almost everything put in front of them before medical examination, hospitals ‘obtain’ necessary permission for processing this information and benefit from it.
How does the Blockchain technology fit in?
As commonly cited, the Blockchain technology is a record-keeping method storing the data in append-only blocks on a distributed ledger using the cryptographic algorithms. There is no central authority in the world of Blockchain. The data is chosen and stored on the Blockchain by users in the network. You can find more information on the Blockchain technology here.
As explained above, the problem with the healthcare industry is fragmentation and control. and the Blockchain technology can provide solutions to this problems.
Single medical history comprised of all medical examinations
Regarding the fragmentation and efficiency, the Blockchain technology can help as it provides a single version of the ‘truth’ on a distributed ledger. What does this mouthful expression mean for the patient data? With the help of the Blockchain technology, the medical history of patients can be stored on multiple nodes, which would be different entities operating in the healthcare industry, and it can be also established that the each node has the identical copy, which would remove the procedural burden of gathering the data or repeating the same tests.
Access and control?
When it comes to accessing and controlling information, a little bit detail is required with regards to the Blockchain technology. The technology became popular with the Bitcoin, which is a cryptocurrency operating on a public and permissionless blockchain. Bitcoin’s purpose was to replace the current intermediary-based payment system with a peer-to-peer based system. Hence, it is built in a manner that would allow participation of anyone.
On the other hand, there are also private and permissionned blockchains. Public/private classification indicates who can access to the data on a given blockchain whereas permissionless/permissioned classification is about the question who can add data.
Considering that the medical history of patients is a sensitive and personal information that cannot be stored and made publicly available, we will have to use a private and permissioned blockchain containing different actors. Ideally, there will be hospitals and public institutions storing all the information; patients whose consent is needed to access the data and doctors who are entitled to write data but again with the consent of the patient. Such a scenario solves the above-mentioned problems.
The use of the Blockchain technology in the healthcare industry will, in addition to solving some problems, contribute to the industry in some other ways.
Firstly, it will allow the use of huge amount of medical information for research purposes given that the patient consented. Instead of separate entities working on smaller datasets, such a pooling will help us to have a huge dataset to work on and come up with more effective drugs/operations/cures.
Secondly, the Blockchain technology is used in the genome sequencing projects as well, which is a field full of fragmentation and middlemen. The technology can presumably facilitate the process and cut the costs.
Thirdly, when it combined with cognitive technologies, the data stored on a medical history blockchain can be used to improve automated diagnosis. It will not only increase the speed of the diagnosis process but also allow people who do not have access to a developed healthcare system to benefit from such an automated system, at least for simple cases. From the doctors’ and researchers’ perspective, such a system would reduce the time they have to spend on simple cases and let them have their time on research.
Fourthly, the Blockchain technology can be used to track the supply chain for drugs, which is extremely problematic in some regions. Keeping the supply chain records on a blockchain would allow us to check if a given drug is genuine or not in a very short time without additional cost.
Indeed there are different challenges to the implementation of the Blockchain technology in the healthcare system.
First of all, not all patients and doctors are equally digitally accessible. After all, using a blockchain-based system to control and monitor the personal data requires a set of hardware and a certain level of digital literacy. In some parts of the world, there is no readily-established healthcare system, let alone access to a system that could be connected to internet.
Secondly, the industry might object such an implementation as the patient data is a very valuable data that could create a competitive advantage. In order to make such a system work, the governments and regulators must step in.
Thirdly, storing personal information on a blockchain, which is practically immutable, is problematic both ethically and legally. On ethical grounds, storing personal information in a manner preventing the deletion is actually in contrast with the initial claim that the Blockchain technology will give the control to the patient. Accordingly, on legal grounds, such a method of storage may constitute a breach of data protection legislations.
The healthcare industry is indeed a space where the Blockchain technology can make a difference as there are problems with the centralised nature and fragmentation of the industry. However, there are sensitive areas as the main subject is human and personal information obtained from examination of humans. Therefore, we can expect to see the projects keep coming up and the debate is heating-up in the industry.